Senate Majority Leader Mitch McConnell, seen here Tuesday with Majority Whip John Cornyn, is facing questions over his strategy used in crafting the health care bill. (Bill Clark/CQ Roll Call)

Senate Majority Leader Mitch McConnell employed an iron fist over the Republican health care effort, keeping top lieutenants in the dark about key decisions and withholding detailed policy information from the conference as a whole until just before it was released publicly.